None listed
Conditions
Brief summary
Fifth metacarpal neck fracture is a condition commonly referred to hand therapists for management. The method of treatment provided, as well as the frequency and duration of treatment vary widely, due to a lack of conclusive research evidence. This project will determine which of two treatment methods commonly employed by hand therapists is the most effective for the management of fifth metacarpal neck fracture. The findings of this project will enable therapists to decide with confidence which treatment method will produce the most satisfactory functional outcome and is preferred by patients. The results are expected to have implications for decision making about the resources allocated to this condition in the future, both in terms of therapist’s time and expertise, as well as materials used.
Interventions
1. hand based orthosis - which is a custom molded thermoplastic splint commonly used for the management of hand and wrist fractures
2. buddy strapping - alternatively known as neighbour strapping, consisting of velcro fabric used commonly to keep one finger strapped to the adjacent finger for support
Hand based orthosis group will be fitted with a custom-moulded thermoplastic hand splint, which will hold the 4th and 5th knuckles in a 70 degrees flexed position, leaving the finger joints free. T
1. hand based orthosis - which is a custom molded thermoplastic splint commonly used for the management of hand and wrist fractures 2. buddy strapping - alternatively known as neighbour strapping, consisting of velcro fabric used commonly to keep one finger strapped to the adjacent finger for support Hand based orthosis group will be fitted with a custom-moulded thermoplastic hand splint, which will hold the 4th and 5th knuckles in a 70 degrees flexed position, leaving the finger joints free. The orthosis will be secured to the hand using three Velcro straps. Orthosis will be fitted at the time of inclusion. Orthosis group will be instructed to remove orthosis for light functional activities, from the 3 week visit, and discard the orthosis at 5 weeks. Buddy strapping group will be fitted with two soft fabric and Velcro buddy straps, which will be used to splint the fifth finger to the fourth finger. Buddy strap will be fitted at the time of inclusion. Buddy strap group will be instructed to commence light functional activity as tolerated. Participants will be instructed to wear buddy straps daily for 5 weeks. Both groups will be instructed to remove their device for skin hygiene daily. Study interventions will be performed by Physiotherapists and Occupational Therapists. All participants will be followed for six weeks. Clinical assessments will occur at the time of inclusion, one week, three weeks and six weeks. Each participant will see their treating physiotherapist or occupational therapist first to check device fit, and to monitor compliance with the device. Compliance will be monitored by asking the participant if they have been wearing the device. The therapist will then remove the device to allow blinded assessment by a research assistant (Physiotherapist or Occupational therapist). Each intervention will take place in the hand therapy treatment room of the Westmead Hospital Allied Health Department; will be delivered face to face and will be 30 minutes in duration.
Sponsors
Tracey Clark
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adults who present to Westmead Hospital with a fracture of the fifth metacarpal neck, and who have been assessed by medical staff as suitable for non-operative treatment, will be included in the study. Inclusion Criteria will be: Volar angulation of fracture up to 70 degrees, as measured from the lateral x-ray; and no fracture rotation. To assess rotation, the referrer will compare the affected and contralateral hands. Normally, all fingers point to scaphoid tubercle, and deviation from this alignment may indicate a rotated fracture fragment
Exclusion criteria
Children and people with an intellectual or mental impairment have been excluded from this research study because of their potential inability to provide written and informed consent. This group may also be unable to understand and actively participate in the treatment protocol.
Outcome results
None listed